The need for increased academic physician-scientists in Pediatric Critical Care Medicine, and collaborative rigorous investigation of new treatment modalities with focus on pathobiology and long-term morbidities is clear. This renewal application requests the resources to continue our four-year post-doctoral research training program in Pediatric Critical Care Medicine within the Department of Pediatrics at the University of California, San Francisco. The goal of the application is to increase the number of highly trained, successfully funded and sustainable pediatric critical care physician-scientists, who will perform high level laboratory and/or clinical- translational research that will ultimately improve our understanding of the pathobiology of critical illness, improve short and long-term outcomes, and reduce the incidence of children with residual disabilities and/or chronic disease. To this end, this program aims to provide comprehensive science training and mentoring career development for pediatricians with an M.D. or M.D. /Ph.D. degree who commit themselves to an academic career with a strong research component. The key elements of the training program are (1) a mentored research experience, (2) scientific course work, (3) career development workshops, (4) interdisciplinary experiences, (5) continuing review and evaluation. The centerpiece of the program is the continuation of a 4-year fellowship training program, with two years devoted to intense research training in basic laboratory science, clinical-translational science, or epidemiology related to pediatric critical care disease. A large number of exceptionally qualified faculty has committed their support as mentors for fellows supported by the proposed training grant. These faculty are affiliated with several of the UCSF campuses and organized research units and programs, which include the Cardiovascular Research Institute, the Department of Epidemiology and Biostatistics, the Biomedical Science Program, the Program in Biological Sciences, several UCSF clinical campuses, and Oakland Children's Hospital. All fellows will take courses in (1) Responsible conduct in research, (2) Scientific writing and (3) The art of lecturing. A Trainees Mentoring Program will support post-doctoral fellows in their training and career development. Fellows will be matched with three faculty mentors on entry into their training; the mentors will meet with the fellow on a regular basis, to assist him/her in setting and monitoring training and career goals. The Division of Critical Care Medicine has a strong track record in recruiting and training pediatric sub-specialists. Of the 5 trainees who have completed the training program, three have already been awarded NIH K awards (60% rate of K awards), and one of the remaining two is submitting a K award in June. All 5 have academic faculty appointments. Thus, the rationale for this renewal is based on the well-documented need for well-designed training programs to prepare pediatric-scientists for a sustained productive career in Pediatric Critical Care research and the fact that UCSF has the vision, experience and infrastructure to train the next generation of leaders in pediatric science. PUBLIC HEALTH RELEVANCE: The need for increased academic physician-scientists in Pediatric Critical Care Medicine, and collaborative rigorous investigation of new treatment modalities with focus on pathobiology and long-term morbidities is clear. The goal of the application is to increase the number of highly trained, successfully funded and sustainable pediatric critical care physician-scientists, who will perform high level laboratory and/or clinica- translational research that will ultimately improve our understanding of the pathobiology of critical illness, improve short and long-term outcomes, and reduce the incidence of children with residual disabilities and/or chronic disease.